Diagnostic utility of fluorodeoxyglucose positron emission tomography in prosthetic joint infection based on MSIS criteria
| Autor: | M Kiran, T D Donnelly, Gunasekaran Kumar, Viju Peter, Catherine Armstrong, B Kapoor |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Prosthesis-Related Infections Osteolysis Aseptic loosening Musculoskeletal infection Sensitivity and Specificity 030218 nuclear medicine & medical imaging Fluorodeoxyglucose positron emission tomography 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 Preoperative Care Humans Medicine False Positive Reactions Orthopedics and Sports Medicine Prospective Studies Aged 0303 health sciences 030306 microbiology business.industry Prosthetic joint infection Middle Aged medicine.disease Positron-Emission Tomography Female Surgery Hip Prosthesis Radiology Radiopharmaceuticals business Follow-Up Studies Total hip arthroplasty |
| Zdroj: | The Bone & Joint Journal. :910-914 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.101b8.bjj-2018-0929.r2 |
| Popis: | Aims Prosthetic joint infection (PJI) and aseptic loosening in total hip arthroplasty (THA) can present with pain and osteolysis. The Musculoskeletal Infection Society (MSIS) has provided criteria for the diagnosis of PJI. The aim of our study was to analyze the utility of F18-fluorodeoxyglucose (FDG) positron emission tomography (PET) CT scan in the preoperative diagnosis of septic loosening in THA, based on the current MSIS definition of prosthetic joint infection. Patients and Methods A total of 130 painful unilateral cemented THAs with a mean follow-up of 5.17 years (sd 1.12) were included in this prospective study. The mean patient age was 67.5 years (sd 4.85). Preoperative evaluation with inflammatory markers, aspiration, and an F18 FDG PET scan were performed. Diagnostic utility tests were also performed, based on the MSIS criteria for PJI and three samples positive on culture alone. Results The mean erythrocyte sedimentation rate, C-reactive protein, and white cell count were 47.83 mm/hr, 25.21 mg/l, and 11.05 × 109/l, respectively. The sensitivity, specificity, accuracy, negative predictive value, and false-positive rate of FDG PET compared with MSIS criteria were 94.87%, 38.46 %, 56.38%, 94.59 %, and 60.21%, respectively. The false-positive rate of FDG PET compared with culture alone was 77.4%. Conclusion FDG PET has a definitive role in the preoperative evaluation of suspected PJI. This the first study to evaluate its utility based on MSIS criteria and compare it with microbiology results alone. However, FDG PET has a high false-positive rate. Therefore, we suggest that F18 FDG PET is useful in confirming the absence of infection, but if positive, may not be confirmatory of PJI. Cite this article: Bone Joint J 2019;101-B:910–914. |
| Databáze: | OpenAIRE |
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